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ClinChem Test 2 Prep

Urinalysis test for Clinical Chemistry Del-Tech Owens After Review

What is the amount of renal blood flow for the average sized person? 1200 mL/min
What is the amount of renal plasma flow for the average sized person? 600-700 mL/min
Particles below what molecular weight, in Daltons, are allowed to pass through the glomerulus? 70,000
Name 3 factors that influence the filtration process? 1. Cell structure 2. Hydrostatic and oncotic/osmotic pressure 3. RAAS
How much filtrate passes through the glomerular every minute? 120 mL/min
What is the specific gravity of ultrafiltrate? 1.010
How much is the glucose threshold? 160-180 mg/dL
If there's 120 mL of filtrate passing through the glomerular every minute, how much is that per day? 172.8 Liters or 172,800 mL
What is the greatest source of error while running a creatinine clearance test? Improperly timed specimen
The amount of creatinine that is completely removed from the plasma in 1 minute is called the ? glomerular filtration rate
How is the GFR reported? Milliliters per minute (mL/min)
How do you calculate the GFR? Milliliters in 24 hour specimen/minutes collected: If 24 hour specimen=1440 mL, then you multiply the number of hours (24) by the number of mins per hour (60) which also = 1440. So the GFR=1 because 1440/1440=1
Creatinine is produced as a result of muscle ? destruction
The larger the person, the __ creatinine they will produce. more
The average amount of creatinine produced by men is ? 107-139 mL/min
the average amount of creatinine produced by women is ? 87-107 mL/min
Creatinue values will be __ in the elderly. lower
Serum levels of cystatin C directly reflect the ? GFR
Cystatin C is a small protein produced by __ __ __ and that is filtered by the glomerulus. all nucleated cells
Explain what the GFR represents. The amount of creatinine that is removed from blood plasma every minute.
Freezing point osmometry is based on ? freezing points
PAH is a test for renal ? blood flow
PAH is an __ procedure. exogenous
Cystatin C is filtered by what part of the kidney? glomerulus
PAH is secreted in the __ __ __, not by glomerular filtration. proximal convoluted tubule
PAH is loosely bound to __ __. plasma proteins
Cystatin C is absorbed by what part of the kidney? renal tubules
PAH is completely removed from the blood each time it comes in contact with functional ? renal tissue
What 2 components are always present in urine? Creatinine and urea
Name 3 inorganic components that are part of urine? 1. chloride 2. sodium 3. potassium
How much cystatin C is secreted by the kidneys? None
The average range for urine excretion is ? 1200-1500 mL
Urine excretion within this range is still considered normal. (HINT: range is wider than 1200-1500 mL) 600-2000 mL
Someone who excretes less than 400 mL of urine every day has ? oliguria
Name 4 causes of oliguria. 1. vomiting 2. diarrhea 3. perspiration 4. severe burns
No urine excretion is called ? anuria
Name 2 causes of anuria. 1. severe kidney damage 2. decreased renal flow (blockage)
2-3 times the urine excretion at night than in the day is called ? nocturia
Excreting more than 2.5 L/day of urine is called ? polyuria
Someone with polydipsia does a lot of what? drinking and urinating
Someone with increased urine excretion because they need to excrete excess glucose that has not been reabsorbed from the ultrafiltrate has ? diabetes mellitus
Someone with diabetes mellitus exhibits __. polydipsia
What are 2 telltale signs of diabetes mellitus that can be detected in urine? 1. urine is dilute 2. has high specific gravity 3. glucose
How much urine does a person have to excrete to have oliguria? less than 400 mL
Someone with decreased ADH that cause decreased reabsorption of water from ultrafiltrate has ? diabetes insipidus
Someone with diabetes insipidus has dilute urine with a __ specific gravity. low
Name two things that diabetics with diabetes mellitus and diabetes insipidus have in common. 1. Urine is dilute 2. polydipsia
How much more urine does someone have to excrete at night than during the day to have nocturia? 2-3 times
How much urine does a person have to excrete to have polyuria? more than 2.5 Liters per day
Someone with increased glucose in their urine has diabetes mellitus or insipidus? mellitus
Which kind of diabetes is due to a lack of insulin? mellitus
Unless it has been refrigerated, urine samples need to be in the lab within __ hours of collection. 2
Should you accept a urine sample that is unlabeled or if the name on the label didn't match the name on the requisition? No
If a urine container is contaminated with feces or paper, can you accept it? No
What 7 urine values will go down (decrease) if a sample is left out 3+ hours. 1. clarity 2. glucose 3. ketones 4. bilirubin 5. urobilinogen 6. blood cells 7. casts
What 6 urine values will go up (increase) if a urine sample is left out for 3+ hours. 1. color (darkens) 2. odor 3. nitrite 4. bacteria 5. pH 6. tubidity
Which kind of urine sample is ideal for urine screening? first morning specimen
First morning urine specimens are more __ than random specimens. concentrated
What is the first step during a 24 hour urine collection procedure? Give patient written instructions, container, and preservative for specimen.
What is the 2nd step during a 24 hour urine collection procedure? Day 1: patient voids and discards first specimen of the day, then begins to collect all urine over the next 24 hours in container.
What is the 3rd step during a 24 hour urine collection procedure? Day 2. patient voids and adds his urine to previously collected specimens.
What is the 4th step during a 24 hour urine collection procedure? Patient arrives at lab where the the full 24 hour collection of urine is mixed. It's volume will be measured and recorded.
What is the 5th and final step during a 24 hour urine collection procedure? An aliquot of the urine specimen is saved for testing. The remaining urine is discarded.
Accurate __ of a 24 hour urine specimen collection procedure is critical for good results. timing
A 24 hour urine collection procedure must begin and end with an __ __. empty bladder
A clean catch urine sample is one where the genital area has been __ before urinating. cleaned
What are the most common sources of contamination for a pediatric urine specimen? feces and talc
What is the normal range of urine pH? 4.5-8
A __ amount of protein in urine isn't a cause for concern. trace
More than a trace amount of protein in urine is most indicative of ? renal disease
Protein in the urine is a condition known as ? proteinuria
You can normally find less than how much protein in the urine of a healthy person? less than 10 mg/dL
What kind of protein is of primary concern when testing urine? albumin
If found in the urine, Bence Jones proteins indicates what condition? multiple myeloma
Prerenal proteinuria affects the __, not the kidneys. plasma
Diet and metabolic factors are __ causes for proteinuria. prerenal
Glomerular damage or tubular problems are causes of __ proteinuria. renal
Fanconi syndrome is an example of __ proteinuria. renal
Toxic substances and viral infections can cause what kind of proteinuria? renal
If someone's urine proteins levels change based on what position they are in, they have __ __. orthostatic proteinuria
Menstrual contamination, semen, prostatic fluids, vaginal secretions, and traumatic injuries are all potential causes of __ proteinuria. postrenal
Name 3 intermediate products (ketones) of fat metabolism. 1. acetone 2. acetoacetic acid 3. beta-hydroxybutyric acid
Of the 3 products of fat metabolism (ketones), which cannot be tested for? beta-hydroxybutyric acid
When are ketones produced in the body? When the body burns fat for energy
Ketones may appear in the urine if blood __ is too high. glucose
People with ketones in their blood may have ? diabetes or ketoacidosis
Without insulin, glucose in the blood can't be store and used for __. energy
Clear, red urine can be caused by __. DIC or hemolytic anemia
Cloudy, red urine can be caused by __. Blood cells in the urine
Hematuria is? intact RBCs in cloudy red urine
Hemoglobinuria is? hemoglobin in clear, red urine
If you have no urobilinogen in your urine but bilirubine is high, you have ? bile duct obstruction
If you have some bilirubin and medium levels of urobilinogen in your urine, you have ? liver damage
If you have no bilirubin in your urine but high levels of urobilinogen, you have ? hemolytic disease
Nitrites and leukocyte esterase are produced as a result of an ? infection or UTI infection
Ascorbic acid can create false negatives for what tests on a reagent stick? glucose, blood, bilirubin, nitrite, LE
Name the 3 primary causes of ketones being found in the urine? 1. diabetes mellitus 2. vomiting 3. starvation/malabsorption
If bilirubin is present in a urine sample, shaking it will produce what color foam? yellow
If bilirubin is found in a urine sample, this suggests the patient may have ? hepatitis virus/liver disease
Patient's with malignant melanoma may have what color of urine? black
Direct measure of a samples specific gravity can be obtained with what tools? urinometer, HOD
Name 2 indirect methods for obtaining specific gravity of urine? refractometer, reagent strip
What are 3 substances that can be used to calibrate a refractometer? 1. distilled water 2. 5% sodium chloride 3. 9% sucrose
If specific gravity of urine is off the scale, you can __ it to get a result that can be read. dilute
A 1:2 dilution of urine with a reading of 1.030 will be recorded with a specific gravity of ? 1.060 (2 x. 030)
What 3 tests are first morning specimens preferred for? 1. routine screening (random also used) 2. pregnancy tests 3. orthostatic protein
A colorless urine sample could be due to ? recent fluid consumption
A pale yellow urine sample could be due to ? polyuria, diabeted mellitus, dilute random speciment
A dark yellow urine sample could be due to ? concentrated specimen
An amber urine sample could be due to ? dehydration (which could be induced by fever or burns)
An orange urine sample could be due to ? bilirubin
A yellow-green or yellow-brown urine sample could be due to ? biliverdin (oxidized form of bilirubin)
A green urine sample could be due to ? *Pseudomonas* infection (remember to underline this answer for italics)
A blue-green urine sample could be due to several causes. Name 6 of them. 1. Ellavil/amitriptyline (same thing) 2. methocarbamol/Robaxin (same thing) 3. clorets 4. indican 5. methylene blue 6. phenol
A pink/red cloudy urine sample that tests + for blood could be due to ? RBCs in blood (hematuria)
A pink/red clear urine sample that tests + for blood could be due to ? Hemoglobin (hemoglobinuria)/myoglobin
A sample with hemoglobin in it could be due to ? intravascular hemolysis
A port-wine colored urine sample that tests negative for blood may be due to ? porphyrins
If RBCs in the blood oxidize into methemoglobin, the sample could turn ? brown-black
Methemoglobin is __ hemoglobin. denatured
For genetic reason, some people who eat beets may excrete what color of urine? red
Homogentistic acid (alkap-tonuria) can turn urine what color ? brown-black
What are the 5 descriptions for urine clarity, from highest clarity to lowest clarity? clear, hazy, cloudy, turbid, milky
Metronidazole (flagyl) can urine to __ upon standing. darken/turn brown-black
Hemoglobinuria will be accompanied by what color of plasma? red
Myoglobinuria will be accompanied by what color of plasma? clear
What is the refractive index, which is used by a refractometer to measure specific gravity? a comparison of the velocity of light in air with the velocity of light in a solution.
Specific gravity is a comparison of a __ __ of distilled water with another solution, like urine, that is influenced by the number and size of the particles present. similar volume
Osmolarity is related to __ __, but is unaffected by the size of the particles present. specific gravity
How does urine travel from the kidneys to the bladder? ureter
A word for low urine excretion but for a level that's still higher than oliguria (which is excretion of less than 400 mL) is ? dysuria
Urine with a "mousy" smell is probably due to ? phenylketonuria
Orthostatic proteinuria manifests when the patient is __ but disappears once the patient is __ __. standing, laying down
Pyuria is __ in the urine. pus or WBCs
Created by: IsaacJ